Local negative pressure technique in abdominal surgery: advantages, disadvantages, controversial issues

Abstract

A literature review of studies on the use of local negative pressure technique (vacuum therapy) in abdominal surgery is presented. The article highlights modern approaches to its use in emergency pathology of the abdominal cavity and retroperitoneal space. The mechanisms of action, advantages and disadvantages of the local negative pressure technique, as well as the main morphofunctional aspects of its application are discussed in detail. Data from recent clinical studies and meta-analyses are summarized, and the effectiveness of using vacuum-assisted laparostomy within the framework of the «damage control» concept in multi-stage surgical treatment of injuries and urgent abdominal diseases accompanied by abdominal sepsis is demonstrated. The use of local negative pressure techniques can reduce postoperative mortality, as well as shorten the length of hospital treatment of patients. However, despite the obvious positive effect on the course of the wound process, vacuum therapy carries the risk of developing serious complications, the most dangerous of which are bleeding and perforation of hollow organs. In addition, it requires very expensive equipment and consumables, as well as training of medical personnel. Thus, the use of vacuum therapy requires a sound approach and a clear understanding of the technical features of its implementation. However, the indications for the use of local negative pressure in abdominal surgery have not yet been clarified, which undoubtedly hinders the wider introduction of this promising technique into clinical practice.